Medicare’s quarterly update to the Practitioner Services Medically Unlikely Edits (MUE) are effective July 1, 2018, adjusting CCR §9789.19. The changes are available on the CMS website.

Changes to reimbursement are as follows:

Procedure Code

Status Code

Procedure

Modifier

Reimbursement (Non-Facility) June 30, 2018

Reimbursement (Non-Facility) July 1, 2018

Reimbursement Change

G0460

A

Autologous prp for ulcers

N/A

By Report (BR)

$267.69

$267.69

Q0477

X

Pwr module pt cable lvad rpl

N/A

$121.99

$883.62

$761.63

71045

A

X-ray exam chest 1 view

N/A

$28.01

$31.17

$3.16

71045

A

X-ray exam chest 1 view

TC

$15.57

$18.73

$3.16

DMEPOS

A June 18 order[a] adopts the Medicare Interim Final Rule With Comment Period (CMS-1687-IFC) regarding adjustments for rural and non-contiguous areas. The DWC also adopts revisions to the Durable Medical Equipment Fee Schedule effective July 1, 2018.

We’ll keep readers updated on any further changes to the OMFS. And — as always — DaisyBill clients can rest assured that our software is up to date with the latest information necessary for accurate reimbursement calculations.

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